ermold



G. ERMOLD.

SURGICAL INSTRUMENT.

Reissued Mar. APPLICATION :FILED MAY 21'. I9l9. 2 SHEETS-#SHEET l.

G. ERMOLD.

SURGICAL INSTRUMENT.

APPLICATION FILED MAY 2T, |919. V Reissuerl Mar. 22, 1921. 15 5071 @www - UNITED STATES" PATENT QFFICE.

eiionea miroLn, or' NEW Yoan, N. Y.

' 1 Y iixfknown that I, GEoiieE Eamonn, a

izeli` .the United States, and-resident of l li of hatten, in the county ty, of ew York, have invented rtaiiu and useful Improvements 1n A' ruiiients, of which the followla specification.vb j we .prenant invention relates to improve- "flo -antsfinprgicalinstrumentg and particu- ArlyP instruments known 4in the proer il as-surgical snai-ee, Tand used prin- Vgipall -fortherernoval ci tonsils. One obxctothapresent embodimentofmy inven- 16. nkiathe'ptoduetion of auch an instrument ii-180 if. 0 cmgsher, I n

A sti further object 1s to providei a v .'feraihera-ivichwill at the same time seprovide and securely holdand retain severedmember and to'v provide at the 135 sg'iietiii-i4ae Arifect cutting action-in connectothe end thlt the operation -mgy be oarriedon-in a convenient, safe, and

we :muelnvx i lt s almjproposed toV provide an instruf iretgrom projections, and ofauch g that the same may thee atients mouth without a,great deal of discomfort, and .gliihwiR- atthe' Sametime permit the sur- 4e operate in an @cient-manner.'

' Further. objects are simplicit of cons tigtioii, of convenient disas- 14. C. .1, theparts for cleaning purposes, 1 and. the of af detachable cutting fgov:- emberjjgiicli may be readily renewed, or

.et and otlieil objects in-view,.an 1l tof my invention` 1S Showmby the line 5 5 of Fig. 2; westweisnt action-S, namely, pr-

Speeioatioaof leiasued Letters Patent. Reiggued Rfar. 22 1921.

une apra a, isis, sei-iai No. 204,341', mea november ss', iei7. Anuman for mnu. aieiiny a1, i9ia.j anni in. scossa. x

way of example, inthe accompanying drawings, and this embodiment will be hereinafter more fully described Vwith reference thereto, and the invention will be pointed out inthe claims.

In the accompanying drawin Figure 1 is a side elevation osan instrument embodying my invention; i f

Fig. 2 is a top plan view thereof;

Fig. 3 is a bottom lan view of the same, the handle being bro en away;

Fig. 4 is a longitudinal vertical sectional view;

Fig.

vfinally 5 is aftrans'verse sectional view along Fi 6 is a transverse sectional view along the line 6-6 of Fig. 2;

Fig. `7 is a rfragmentary plan view showing the retaining member turned into position to permit disassembling of the parts;

Fig. 8 is a plan View with parts broken away, of the cutting member and the slide plate for operating` thesame; v

Figs. 9, 10 and 11 are views partly in section and partly in elevation, showing respectively the initial operated position of the parts, the second position in which the crushing member has been full operated,

and the cutting member broug t into its ition prelimina to cutting; and the nal position in which the cutting member has'beenfully operated; Fig. 12 is a planfview with parts broken away, showing the mechanism for operating the crushing` member in its position just prior to operation;

Fig. 13 is a vertical sectional view taken along the line 13-13 of Fig. 12;

Fig. 14 is aV View similar to Fig. 12,`show ing the mechanism in its operated-position;

and f Fig. 15 is a vertical vsectional view taken along the linej15-15 of Fig. 14.

Similar reference characters indicate corresponding parts throughout the several figures of the drawings. Y

Referring to the drawings, and more particularly to Fig. 1 thereof, the present embodimeiit of my improved device comprises a longitudinal supporting base 20, referably flat at its upper side, and rounde at its under side, provided at its forward end with a laterally disposed guide head or nose 21,

'y n havngjan npstamding rim` portion22 exf tendingfa'bout the'isides and frontend there# of, and providedv with. an elliptical aperture l23 adjacent the 'forward.pend. Thelrearend:

of the base,l is "slotted ae at 2li-,and 'terminates in an enlaredfopen f ortionrg2509x114.y f .municatingywith t" eslot, ann having itsy rea-r wa1l26 obliquely disposedatheshape otthe yopening fin the present embodiment" `being l lo v v 'substantiallv trapezoidal: "f

A dependingy handle S2/@y `"forked atiiteupper" l end as at.28embracesthe base portion20in front of andadj'acentthe enlar "d open por.-

f v ing Slightly `"over the base, and .having 1 their inner faces beveled. The"""open portion of y vthe forkdendio'f the handleextend'e downl ,y 'wardlyf'fromfand"communicatee 'with the n, p20 t sl'ot "24 of tliebee'f7v v p A knifelffoperating fslideplate 31j is' disposed' at the upperside df the base'20, and is lprovidedat itsy rear endvvith a reduced 2rporvtion 32;'tojthe underside yof' which isy secured a neckBS providedv at'itsouter'end with af 5 cutting member v 39. f

slidel` isfcut'invvardly' 'as'f'at and 36 toy a i "circular `headv portiony 37, which vadapted-1 (-,finterlockingly engage a correspondingly shaped Aout-outfportion 38jo`fl the knife or The cuaingmember esjieprovidea' with an,parcuatecutting edge-*40,1 beveled atfitsv` ynnderdidefaset 413, andthe longitudinal' edges "of the said member' kengage guide? slotsy 21'51"The orwardf'end oftheheadw21"*sub4 stantial'ly conyfomnejin Shape: toth'e` cutting p edge 40,- iand. is .providedfwltha slot Zift-into 1- nl jovedfr? whichttheycnttlng edge is'fadaptedto be A pinar side-ofthe s e provided a the pper li e providin it l being liftedfrom t je base,` thethumb Piece 34' being free tomove-'through the open porortion' 32 permit-fy ,j tingthepa'ssage"ofthe'slide yplatebetween.

- g theanges'QQ-eandeo;41L; f

At the upper side ofthe Slide platef `therefiezprovidedfa reciprocating crusher bar y 50,prov1'dedlatits forwardend ywith a; later#y f ally-'disposed Crusher-'head1 51,1 having anfj'arf ['cuatey edge 52,2;somevvhat blunt, l and havin I t itSlog'i'tudinali-side edges 53fand"'54;beveled `1 i at theirfunderrfsides, and dieposedin guide hold tln'atonsil;ory 'the severingfthereofrl: e y

Hortionf of the crusher bar f at theend yofthesaid barthere'ie provided:

platel 31, and ,rearwardly vof the seme there 1s provided lal longitudinal slot-46 adaptedlto permit movementk offjthe p slideplate'with refpect to .theshank of fa. re#` tainingmember, which `,vvil-l vbe, resentl'y i more fully described@ 'When' the "slideplate 31 is movedl forwardlyv tofthfeposition; mdify cated 1l,-the1feduced end 32ithereof,k

y l 1eother parts' ofthe instrumentf v waredetwc ed,"wi11 "ermit:offt'heslideplate'l thereto, but locks the same! i 51'is Slightly yin, widthl than the cutting member 39,` so thatv yit is impossible to faccldentally place the .cutting member inthe slots v5h.5\of'th,eifel-,naher head, the distancey bef tween these slots, it will be understood, `ibeyinwcgqalso.lessthan the width ofthe cutting vmember. The arcuate edge 52 substantially conforms.y tok interiorjof -the arcuate mforwardend ofthe rim 22, and co eratee there l lwitlraofp"reducera crushing ye een and L'also n orretainlngmeanstof provideev'a grippi' iis 1ikeefprwd--ftf The"l,rearwardlv p i y 5'0 i'svlongitudina y 'channeled yas at 57, jand an upetendir1geupportfBgik l y v A slot'61 1sy provided arwardly ofthe crusher head;l and enga' thelug or pin 45 of the slide plate 31, an vbetweenthisslot 61 andthe channel`57, there is'provided a llon i@ shaped opening in the'base' 20, the said o ropenin :being surrounded 'at the under side of the ase 20'by'lalfsubstantiallycircular re,- i cess 'ce -1 A sp1-1n .-reminingimember 65; is -provided vvitlrav` s ankfyhavingfa knob 67u at the end? thereo'fwadaptedjto befpased throughthe` slotsv 62y and'465 Aand :also the'- openingi in-"thebase,v whenthefsaid mexn-k v ber is turnedatright anglesftdthebasefas indicatedin Fig; 71 When` tl'lrned'intoeline-l i mentfwith the vsaid base-,itis adapted 'tolock-A p i* mitfelidngfmovement Iof thelTrespective v theparts together.' The slots 62' end/46 perjcru'eher bar `andfslide yplatel with reSpect 'to the base'20, "Whilethefslo't' 61 perinitsfnrther slidingmevementyofgthe `glide lparte wenn Y spectjtoy theflcrushervbar; To this end,"l the coinbinedlv lengths of ti1e{sl :s` 62 and: 611'are substantially equal to the length of fthe 'slot p pring r` 11ov o npwar y at its forwardendfasv at 68,'andat itsk rearward end is` providedfwithf an enl larg'edportijo'n 695hav1nga'flng-0at tlleuir der'side"thereofywhich'fengages"the channel f 57,* andiprovided at. `its `rear y'edge f with l a de-` pendlng toothl 71,` adapted to "engage the ratchet,y teci'fl`1f72 cut 'the crusher bar; and

f disposed ateachgside' o'f the Said channel" 57; s These teethl are inclined rearwardly Se that"` "thejtoot 715' byreason 'ofy the resiliency of the# retainin member, "permite forwardr :movement o the crusher var with movement, v .t

member extendsv 'slightly kbeyond thelongh )permltof the said-1retaining` member? beingy against rearward p e--inmlkingiy engage fj Kofthe flan es29 and 30. At one 1 @Aff H1B-.Said eges zo a'.

retain the wedge han e in any desired po-` la: vevhaped y an Y v 'that while-the thumb screw is tightlyI A an l causes-.fthe same to eXPnd Slightly i against miseri 3U mt in othex direction.

f'i ,1w phd which V'permit of the disengagement of Crusher bar when the said straight cut po ns are brought into relationvr with the said anges. L

1i., The upstanding sup rt 58 isY provided i Vj leiith a stud 59 upon w ich there is secured tytubular shaft or spindle 60. The shaft 60 Y lfsee Figs-. ft; and 13), is split from the outer and for the` eater part of its length asl at 76 and 77,' ormingthereby a spring shaft 120 upon which there. is rotatablyY mounted a cgusher handle com rising a s eeve 78 proded-interiorly wit a spring lining 79 secured `to the sleeve, and adapted to be Slightly expanded outwardly, and which co- '-r with the spri shaft 60 to securely sition. At'the forward portion of the sleeve 7B-there is provided a spiral cam portion 80, and at its rear end there are providedwing handle portions 81 and 82. A dat "i Hiring 83d: ,provided on the shaft 60 between thegnpport 58 and the cam rtion lik-end il. prevented from Yrotation v enent of a-reeess 84 therein, with a pin 85 provided on the upstanding support 58.

' mining-thumb screw' 86 is secured in the screw threaded -bore 60 of the shaft 60, a shoulder 87 thereof engaging the'end of rry the said shaft, while a second shoulder S8 z41o loosely g. A i' i 4 4an annular recess 89 proe handle, so

e is lend of the w cured to the shaftO, the wedge vnot prevented from rotation, the flat spring Tias @holding thewedge handle always i re' sientei t with the fiange 89.'. The meufv of the screw 86 with the shaft -79 thereby rm, x a

-l 151) a. ho dl-for e wedge handle.

arcuate slot 90 is provided on the inner face Aof the l cam portion 80, ex-

the enlarged end of the said to" a iluzern'iedi'atel the en- .andjthe small end of the same, and

g tes with the pin-85 to limit the move Heut in om direction 'of the wedge handle,

if the engagement ofthe pin with the small 'l dal of the 9am portion 80 limiting the moveaorded by the wedge handle w intended for use-where avery efect is dil'ed, the

brought to the j "il Figgl, which is the pusi- Vcrusher bar is moved forwardly to the posimemlzier has been moved forwardly during 'sitions. the thumb and forefinger are ention preliminary to the crushing, so that the cam portion is in operative relation with the enlarged portion 25, the spiral surface of the cam coperating with the oblique wall 26. upon turning of the wedge handle, to slowly move the jcrusher bar forwardly with a very powerful crushing action. The operation of my improved instrument is as follows: Fig. 1 represents the parts prior to the forward movement of either the crusher bar or cuttingV member. I will first describe the operation of the instrument without bringininto play the wedge handle.

Referring to igs. 1, 9, and 11, theinstrument is first placed in the throat of the patient, with the parts in the position indicated in Fig. 1, in which the velliptical aperture 2.3l is Yfully open. B means of thev thumb engaging the thumb screw 86, the

tion indicated in Fig. 9. During this movement, it will be noted, the slot 61 causes the cmsher bar to also move the slide plate 31 and the cutting member forwardly.

From the ition indicated in Fig. 9, the crusher bar 1s forced forwardly to the position indicated in Fig. 10, the ratchet teeth during this action preventin `any backward movement of the crusher ar, so that a powerful crushing action results, and by cooperation of the blunt edge 52 of the crusher head with the closedv forward end ofthe nose of the head 21, a gripping action results. As above pointed out, the knife or cutting this action, and isbrought to the position indicated in Fig. 10, preliminary to cutting. The thumb is now engaged with the thumb piece 34, andthe knife or cutting member is forced forwardly, the cutting edge entering the slot 44 and completing the operation, as indicated in Fig. 11. In order to move the parts back to their original pogaged beneath the enlarged projecting por- 11o tions of the spring retaining member 65, and the tooth 71 is lifted out of engagement with the ratchet teeth 72. By pulling with the other hand the parts may be retracted. The pin 70 is slightly longer than the tooth 71, 115 so that during this action, the same is not disengaged from the channel 57.

Y In order to disassemble the parts, the spring retaining member is lifted to such extent that thevpin 70 is disengaged from 120 the channel 57, and thereupon the retaining member may be turned to the position indicated in Fig. 7, permitting disengagement of the retaining member, and a consequent releaseof the crusher barzand slide plate. This convenient disassembling and assembling-of the instrument is quite important, in that it greatly simplifies the vsterilizing process, and rmits of the renewal of the cutting member with facility. v lso 1o i i f i t i f'Withgthepresen'@embodimentofmy in` Yentionffit Willj be Seen, ian instrument f isL provided which there is'y 'a prelimix'lary` 4 ci'ushil'igy action "and final ,KWedgQ, sind 15 movement of t i `1n Figs. 12 to 15, I have illustrated/the {action'ofr the Wedge handle, Fig. 12 showing the position off the lartsfpreliminaryto the lfligi lfifshowirig the vfinaly f position. "'The inf85vprevents `further' c iie'spiral cam `whenV fthe i crusher baris`lmov`ed to its full forwardpoa.

A'Wedge faction, and

i', sition,` sol 'that any further movement which might break theend of the headl or nosef21`,

isprevented; ,f

crushing ei'ect, ,the `'cuttingfmember `being -broght 'imprehminary position by this action, andan independentfmovem'ent ofthe c prevent proper sterilization.' rEhe slender k dimensions of i the base and,` the" co partsk aiord-fsuch` anrinstrnmentft atewill bey comparatively 'comfortablefto the patient,"

and" :which 'will-"permit ofthe physician or surgeon operatingfin afmuch more efficienti' [cutting member jafterthef'crus'hing action. i

-' f 'The instrument is'gsimple `in construction,

tionabley 'corners andf'creyices which "might `mannerth`anheretofore possible. v

' reciprocating (Saidcuttingmemberf ti on of said secondary :member :'reciprocate.

v L) I have-illustrated"a:preferred dependent'fof: `said secondary member lfor as defined in? claims.'

t All surgical instrument-ofthe character:

, -idescribed; "cerrlpri'sine'v .a Support, a* cutting :member carried said support, a second# afry eoperating'y memberv carriedf;` byv said support, means `for" reciprocating' said col operating fsejcvondary'niember,` 'and means 111- 2. A urgicallinstrumentffofthe character describedg'comprising arsupportg and "a handle therefor, a cutting @member 'carried i ybyszfiiol support;a;y secondaryflco'perating' vmember carried 'fby said support, means" fory recipiocating`1Said'` secondary? cooperating v ypxmkernber,` "means "for l'reciprocating said tout`-` ting member, f and -members coperatiyely i connectingl saidl meansl Wherebjy'freciproca-` saitl cutting member through afportion ofits :full mo"vement, said yIrie'ans forreciprocating feaid cutting 'memberl having f free f reipro# eating morement'relativel tosa'idsecondary f -f irnember andadaptedto e ect `inWeinent "Ofsaid',cuttingftmember.

.''described, Y comprising f I handle ther-efe` reciprocating: 'sail f l an megane f amm-@wfitiiechamef .ting member; having"freefsliding Lmovement described, "comprising at support anda i l v andvsatisy factory' embodiment of mjryf v'irlvention,fi but g i, itx? ie'` oflw'iousf` :that changesi` may? ymade therein 'with-in thefspiritand', yfseofpe lfthfereof,

- membercarriedfbidsaid support, said mem- 10ol 'reciprocation of*saidwsecondary,,member f i pendent: movement off ssii .i SUPP't i and' aft ycutting member carriedy `secondary coperating l adapted't-Befegagedwby "the thumb fxthe hand engaging said handle to independently vreciprocate said cuttingj n'nember:` l -f '4;' L surgical instrumentiof rthe yclriaracterl ydes"vcribed, compriging :a Support sand@ aat handle therefor, a cutting'member` carried byhsaid`v supp'ort,l allSecondaryl cooperating member carried byfsaidsupport,y s'aidlfcut# to" slide relatively i to Vysaid secon ry gcoperi atingymember, f means fori recip'rocatin','g"f*` said@y *y cfi'tting'-member, andfmea'ns` orfreciprocatingsaid secondary cooperatingl membe'rlf n 5d A""surgi`cal instrument ofthecharacterv handle therefor," a =cutting-member carriedby'jsaid Support? 1and slidablef longitudinally thereof, Jia gripping"v `and?elr'lushing member carriedfeby said "support and Sli'dable longitud'ina'llyi thereof, "i meanef cooperatively `con-, necting said icuttinginember and saidl gripping and I crushingfmember and adapted to reciprocate #Said cutting iniember las' said" gripping and i crushing member lis recipro- @nemend 'cutting member @being- 'nemiauyso. free to-islide relatively to ysaid gripping and n* crushing member, fand means` for 'eli'eeting thefff" sliding movementgof" said Acutting (i. surgical'` instrument` o1"thelcharacter` 95'; described,` `comprising law suppo'rtifv and v*a n handle,l therefor, an cutting `member carried by saidk support;- a secondary cooperating? i bers having a p'i'nand'y slot connection "where'l reciprocatee ysaid cuttingk member, Saidjfslot -permittinggaf further free movement of `said cutting 'memberf independent of said? seconda ary Imeinher;y means"` fory eecting the' recip-4 roca-tion! ofv s'aidf secondary".'memberkfand meansfjindependent'fofsaidf.secondary mene y berforaeifecting inde "eindent movement ofy n "75,1 "surgical yin"strnnmentof; the character described,1='comprisingl ya f support :and f' a handle therefor, a 'cutting'` members 'carried by# saidrsupport, le vsecondarylf'coperating` member-carried -by said `support',` Said; l`cut-y Atingfmember.rjbeingi normali; 'l e towslide y115 relatively to lsaid secondary ff cooperating hand-1 engaging saidhandl 'for reciprocating j the same, iandfmeans'iohf saidjclittmg ffmems-* 1-20 berindependentofeaid secor'liiaryniemberf'] N adapted :to 'beengaged byathe" :thumb "of thev hand' lengaging said handle #'to. eiect z" inde` tured i headY atzone; ndtiof .Saidil Support; a' u cuttingfl-membe carried by'eaidfsupportla secondary cooperating tnie'mber y'carried saidw support; t i incensifor?l i,miepe nde'iitly` ,f 11er i v Emittingmemliersu: i" A.8g-I A surgical instruliieiltf'fof thelcharacter y125 1 described,{;.comprising laf? support; ian afpr- 1 carriedby sai bei' and said secondary member -with recprocating said cutting member and said secondary member with respect to said apertiied head, and an abutment in the path of said secondary member adapted' to form therewitha gripping and crushing means.

@-9. Asurgical instrument of the character described, comprising a support, an apertured head at one end of said support, a

- Hitting member carried by said support,

a secondary coperating'member carried by said'slippot, means for independently reciprocating saidcutting member and said secondary member with respect to said aper- 5 f hired head, and an abutment in the path of `it siid secondary member adapted to form therewith a gripping and vcrushing means, `and means engaging lsaid secondary member and'afdapt'ed to? prevent rearward movement thereof. 10. A' siical Vinstrument of the character descri comprising a support, a head at one endof said support, a cutting member carried4 by said support, a secondary memsupport, means for indpendentiy reciprocating said cutting mem- Yspeist-to*mid head,'said head'having an iperturer'nbrmally forwardly of the for- *be be reciprocated across said aperture, and abutment in the I i" member adapted to orm" therewith a gripath of said secondary ping and crushingY means, and means enging s aid secon ary member and adapted prevent 'rearward movement thereof.

I 1l'lyA.' surgical `instrument of the characdescribed, comprising a support, a cutmember carried by said support and 'comprisin -a slide, and a cutting blade int'yrlocking engaged with said slide'and adapted to be disengaged by being lifted f, therefrom, and a removable secondary coi operating'membe'r slidably disposedv upon cutting member extending over the. iiiteriockn portions offsaid slide and cutting bla e, and adapted to maintain said "interlocking engagement, and means for re- `qciprocating said cutting member and said Secondary member.

12. A su ical instrument of the character descri comprising a support, an apn ertured head at one end of Vsaid support,

" -Said secondary member.

1 pairs of guide flanges at the sides of said head pro- Vguided with two pairsy of guide grooves, one 'of said pairs being wider than the other, a "cutting member slidably mounted in one of `-laid airs of grooves, and a secondary member s idably mounted in said other pair of grooves, said dierence in width of said ooves adapted to prevent interchangea ility of said cutting member and v13. A surgical i strument of the characl' 'eat-'ter described, comprising a support pro- 'vided with opposed guide iiaiiges having inclined upwardly converging inner surfaces, a cutting member carried by said support,

v a secondary coperating member carried by said support and disposed above saidcutting member, a portion of the opposed edges of said secondary member being inclined to interlockingly and slidably engage said Vinner surfaces of said guide fianges to retain said cutting member and said secondary member upon said support, another portion of said secondary member being reduced relatively to said flanges to permit disengagement of said secondary member from said support. l Y

14. A surgical instrument of the charac ter described, comprising a support having an eye, a cutting member carried by said support and having an elongated slot to reg-` ister with saideye, a secondary coperating member carried by said support and havingY an elongated slot to register with said eye and provided with ratchet teeth, a connection means comprising a stem adapted to engage said eye of said support and said slots of said members, and having a head at one end adapted to be turned crosswise relatively to said eye, and a spring retention member at the other end of said stem adapted to engage the upper side ofsaid secondary member and having a tooth adapted to engage said ratchet teeth to prevent rearward movement of said secondary member, and means for reciprocating said cutting member Vand said secondary member.

15. A surgical'instrument of the vcharacter described, comprising a support having -an eye, a cutting member carried by said support having an elongated slot to register with said eye, -a secondary coperating member carried by said support and having an elongated slot to register with said eye, and provided with a longitudinal groove and with ratchet teeth, and connection means comprising a stem adapted to engage said eye of said support and said slots of said members and having a head at one end adaptedto be turned crosswise relatively to said eye, and a spring retention member at the other end of said stem adapted to be engaged at the Y upper side of said secondary member havin a pin slidably engaging said slot of sai secondary member and having teeth adapted to engage said ratchet teeth to prevent rearward movement of said secondary member, andmeans for reciprocating said cutting member and said secondary member.

16. A- surgical instrument of the character described, comprising a support, a cuttin member carried by said support, a secon ary coperating member carried b said support, and means for independent y reciprocating said cutting member and said secondary coperating member, said means for reciprocating said secondarymember com.-

y'prising a rotary cam Wedge, and means cooperating therewith adapted to `reciprocate i said secondaryy member witlirelativelygreat force', f, i, .i f 17;l A surgical instrumentof ,thel character described, comprising afsupport, a cuttindg member carried by-sai'd support, asecon v aryy eoperating member carriedfb .saidysup- 1.10 eatingv said cutting member-and sald secondary "cooperating member, said" 4mean'syfor port, and means for!independent y reciproreciprocatingsaid' secondary 'member comadapted tofreciproc'ate salda` secondary mem-` prising'a @rotar'ycam vWedge carried by said vsecondary member, means foinlimiting the movement thereof, and, meansy carried" by f saidk support cooperating therewith, and

" bervwithrelativelygreat force; f f

18. A' surgical instrumentof the-character described, comprising' a support, a cuttin.

member'carriedby said' support, a secon j ary coperating member carriedb port, and means for independenti7 eating said cuttingimember and saldrsecond- "ary-coperating` member, saidy meansy forl y' prism a rotary cam wedge, meansor fric-` f Y y tional y` retaining-said cam` Wedge in any- Lsecondary .force l f 19'. A sur '35y y reciproreciprocating said ksecondary member comf positionk yof movement, and means coperating ltherevvlth adapted to reciprocate said support, means for sliding said member upon `the'support to effective pos if adjusta' 1e element comprising 'a rotar support, a' s tion includin eleldlrcam carried by and movable wit `said sliding member inthe sliding j movement thereof, and a xed'part Withwhich said elep ment'is adapted to coact,the rotation of thexcam riding the "bevel rofthecam onlthe fixed Apart,v f n x ,g 20; A surgical' instrument comprlsinga said sup-v `member n with` relatively;y 'great e p n .icalfinstrument .comprising a support, als lding member carried by said'` connected Ato said: "member, ysaid ,adjustable .member havingv a rotary beveledfcam yand meansy preventing.` relative `longitudinal l support, and meanslforl reciprocatin said llllflflbr` vincluding` an" .adjustableffe ement *f movemento said reciprocatin member'and bevelr of the cam onfvthe fixed; part.`

'adjustablelelemeng yand VVal re atively iXed part with which said element `is adapted t0- kCoact, thewrotation" of thewcam riding the `55k 21.;A surgical` instrument comprising al support, a slidin member carried by, said support, Imeans or initially," shiftin kthe sliding member'on the support to its e" ective able, element havingv aI rotary,

ridingthe'bevelzofthe cam on the `fixed part.`

lding member icarrie 'by ysaid sur 1ca1' .instrument com rising a support, a5'

support, and means fory reciprocating `said y y,member including afrotary cam element bev-k l y ele'd'y at oneside carried by saidv member and secured 'against'longitudinal kmovement relak v'tive theretoyandarelatively fixed artwitb v Which'said-frotar ,camelementisa aptedto eoact,` the `rotation-fof the cam riding bevel ofthe cam on-the fixed part.

N523.; Asur 'cal instrumenthcom nisirigavr support, a.` s aiding member` carrie Lbysaid"D support,` f means for; initiallyshiftingthev the slidlng memberf on thewsupportvto itsueiec tive position, and camffmeans beveledaty one side carried by `and movable with said-mem#v` ber in ysuch 'initialfmovement thereof, said.

`camv means-adapted to'iicoact. with, a fixed part on the Esupporttosimpart a further slid-k ing movement to said memb1er"the, rotationk K- of the cam ,riding thefb'evelof the cam' onthe sof` 

